Eyelid Disorders Flashcards by Sabha Latif

What is pilosabaceous unit?

Refers to arrangement consisting of hair shaft and follicles

How well did you know this?

Not at all

Perfectly

What is the pilosabaceous unit associated with?

Sebaceous glands and muscle

How well did you know this?

Not at all

Perfectly

How does the pilosabaceous become inflamed?

Due to infection (bacterial/fungal) or infestation (demodex mites)

How well did you know this?

Not at all

Perfectly

What 2 forms can blepharitis come in?

Antetior and posterior

How well did you know this?

Not at all

Perfectly

How can we differentiate between the 2 forms of blepharitis?

Bleph sxs= worse AM

Dry eye sxs= Worse PM

How well did you know this?

Not at all

Perfectly

What ocular sxs may overlap with blepharitis and dry eye related deficiency?

Ocular discomfort 
Dryness
Burning/stinging 
Grittiness
Photophobia
Blurred/fluctuating vision

How well did you know this?

Not at all

Perfectly

What is anterior blepharitis associated with?

Excessive colonisation by BACTERIA, FUNGAL, DEMODEX MITES

Inflammation of lid margins and ocular surface…. inflamm signs associated with crusting/scaling of lashes

How well did you know this?

Not at all

Perfectly

Where is posterior blepharitis often located?

Meibomian glands offices

How well did you know this?

Not at all

Perfectly

What is the common cause of Posterior blepharitis or decline in MG function?

Age

How well did you know this?

Not at all

Perfectly

How common is blepharitis?

40% of population and elderly

How well did you know this?

Not at all

Perfectly

What are posterior eph associated with?

Inflamm of lid margin and ocular surface… inflamm not associated with crusting/scaling

How well did you know this?

Not at all

Perfectly

What are the most common skin conditions associated with blepharitis?

Seborrheic dermatitis

Rosacca

How well did you know this?

Not at all

Perfectly

What is the hallmark of blepharitis?

Chronic!

How well did you know this?

Not at all

Perfectly

What other factors may cause inflammation on eyelids?

Environmental factors

How well did you know this?

Not at all

Perfectly

What signs are associated with rosacea but not seborrheic dermatitis?

Telangiectasia- dilated/broken blood vessels
Puss filled pimple
Rhinophyma- red/purple nose enlargement

How well did you know this?

Not at all

Perfectly

What sxs are common in both anterior and posterior blepharitis?

Lids sxs- redness, lid swelling, crusting, sticky eyelids 
Irritation burning sensation 
Possible blurred vision 
Cls intolerance 
Photophobia 
Increased blinking

How well did you know this?

Not at all

Perfectly

What do all sxs of blepharitis stem from?

Lid inflammation

How well did you know this?

Not at all

Perfectly

What associated conditions are there with lid inflamm?

Conjunctivitis
Dry eye syndrome
Keratitis

How well did you know this?

Not at all

Perfectly

What are the 3 key features in blepharitis?

Bilateral
Chronic
Asymptomatic

How well did you know this?

Not at all

Perfectly

What signs are seen with ant and post blepharitis?

Ant= lash related signs
Post= MGD Signs

How well did you know this?

Not at all

Perfectly

What 8 signs are there in blepharitis?

Lid swelling and redness
Posterior lid
Lash signs (scaling/crusting)
Bulbar and palpebral conjunctival hypereamia
Foaming tears
Debris floating 
Corneal signs
Superficial punctuate corneal erosion

How well did you know this?

Not at all

Perfectly

What corneal signs could be presented in blepharitis?

Inferior punctuate erosion
Marginal infiltrates
Corneal vasc

How well did you know this?

Not at all

Perfectly

What is the 1st line tx for blepharitis?

Cleaning
Heat tx c hot compress
Massage to promote movement of meibum through punctum
Lid hygiene using cotton pad, cooled boiled water/ tea tree oil
Advice pxs on inflamm conditions

How well did you know this?

Not at all

Perfectly

If there is corneal involvement what action would be taken?

Ophthalmological opinion- urgent topical antibiotics/steroids

How well did you know this?

Not at all

Perfectly

What are tx for blepharitis aimed to do?

Ant bleph= Reduce bacteria load Post bleph= improving MG function Attempt both!

What treatment methods can be used for seborrheic dermatitis?

Oral steroids/antibiotics | Anti fungal shampoo and OTX antifungal tx

What 2 types of benign lid bumps are there?

Chalazion and hordeolum

How does a chalazia arise?

Inspissation (thickening) of meibum lipid leading to obstruction of MG ducts. Backed up lipids lead to leakage into surrounding tissue

What is chalazia associated with?

Bleph and skin conditions

What signs and sxs maybe presented in a chalazia in mild/mod inflamed?

Swelling and mild hypereamia | Mild tenderness/pain

What the 1st line treatment for chalazia?

Hot compress daily twice 5 minutes/application | Lid massage and possibly lid hygiene if bleph associated

What is done treatment is unsuccessful?

``` Unsuccessfull after 2 weeks= REFER HES based options available- - Intralesional steroid injection - surgical incision - curretage ```

Where does hordeolum stem from?

Infected lash follicle spreads into glands

What is the onset of hordeolum associated with?

Bleph, rosacea, trichiasis ... usually idiopathic onset

Whats another term for hordeolum?

Stye

Which 2 areas can hordeolums infect?

``` Internal= Meibomian glands External= zeiss glands (anteriorly located) ```

What sxs are associated with hordeolum?

Pain swelling burning sensation

How is hordeolum treated?

Same as chalazia

What is the hallmark for infection in hordeolum?

Pus!

What is the natural lifespan of hordeolum?

2/52 approx and resolves spontaneously without intervention

If the hordeolum persists after 2 weeks, what action is taken?

1st antibiotics | 2nd surgical incision and curretage

What complication can arise for hordeolum?

Cellulitis?

Where is the orbital Septum located?

Anterior section of orbital bone to conjunctival tarsal plate

Who are more at risk of cellulitis?

Children

What are the key features of cellulitis?

Red, painful, swollen lids and unilateral

If suspected, what action is taken?

Same day phone call consultation about need for emergency referral

What is the cause of orbital cellulitis?

Spread from infective sinus disease especially with px with hx of upper respiratory tract infection i.e. pharyngitis, sinusitis, pneumonia

What sxs and signs maybe presented in orbital cellulitis?

Red, swollen, tender eyelid Pain on eye movements Diplopia Fever, unwell, lethargy

How is preseptal cellulitis caused?

Local eyelid injury/defect- insect bite, hx of hordeolum

How can periorbital and orbital ve differentiated?

CT scans

How are both forms of cellulitis tx?

``` Orbital= intravenous injection Preseptal= Oral ```

What is a nodule?

Small swelling/ aggregation cells

Which form of eyelid bumps are nodules more commonly seen in?

Chalazia

What different types of BENIGN eyelid tumours are there?

``` Epidermal inclusion cyst Cysts of zeiss and moll Xanthelasma Molluscum contagiosum Seborrheic keratosis Squamous papilloma ```

Which is the most common form skin cysts?

Epidermal inclusion cysts

What is the cause of epidermal inclusion cyst?

Hair follicle occlusion

Which area of the body can epidermal inclusion cyst NOT be found?

Palm of hands | Soles of feet

What are the signs of epidermal inclusion cyst?

``` Elevated round white lesion Nodular Smooth surface Keratin filled ```

How is epidermal inclusion cyst managed?

Non urgent referral- surgical excision IF sxs ONLY!

Which benign eyelid tumours require a sxs surgery?

Epidermal inclusion cyst | Cysts of zeiss and moll

Which benign eyelid tumours require a cosmesis surgery?

Xanthelasma Seborrheic keratosis Squamous papilloma

What is the cause if Xanthelasma?

Hyperlipidemia (blood disorder= risk factor for CVD) Can be idiopathic

What are the signs of Xanthelasma?

Yellow slightly raised plaques Bilateral Asymmetric Medially located

What does a molliscum contagiosum look like?

Dome shaped Pinkish Isolation or clusters Months to resolve spontaneously

What presentations are seen in seborrheic keratosis?

Brownish | Wart like

Whats another term for squamous papilloma?

Acrochordon or skin tag... finger like flesh

What are the commonest forms of malignant eyelid tumours?

BCC | SCC

What associated risk factors are there in BCC?

Sun exposure m/ sunny climates Fair skin Lower lid prevelant AGE!

What are the presentations seen in BCC?

Pearly margins Ulcerated Centre Not metastasize but invasive!

What action isbtajen with malignant eyelid tumours?

Suspected? Urgent emergency referral to HES 2/52

What 2 types of lower lid abnormalities are there?

Extropian | Entropian

Which muscle is need to keep sufficient horizontal tension?

Lateral canthel tendon

What sxs may a patient experience with the sagging of the eyelid?

Redness Tearing Epiphora FB sensation ... all 2nd to inadequate tar film

Due to the eyelid laxity what cornealn signs maybe presented?

Punctate corneal erosion syndrome.... if scarring then risk of permanent vision loss

What treatment is the for ectropian?

Early stages- topical ocular lube | Oculoplastic surgery often needed

What is 'involutional entroian'?

When ectropian is caused by increase in hz eyelid laxity. Common cause in elderly

What are the less common causes if ectropian?

Cicatricial ectropian- contraction caused by scarring | Paralytic ectropian- transient/permanent disruption to nervous supply i.e. bells palsy

What 2 problems can occur with ectropian?

Anterior lid margin right angled | Lashes turn inwards

What can cause entropian?

Involutional entropian- irregularities if lid skin tension | Cicatricial entropian- contraction caused by scarring of bulber conj

How is entropian treated?

Lid surgery... initiated ASAP via GP seen in 2/52 | Sxs severe?- HES discussion

Eyelid Disorders Flashcards

(80 cards)